Nanomedicine has huge potential in cancer therapy due to its advantages of improving the solubility, increasing the bioavailability and reducing the side effects of anticancer drugs. However, the intratumoral accumulation of anticancer nanomedicine is still extremely low owing to multiple physiological barriers to drug delivery; thus, it is inefficient for cancer treatments. Inspired by the communication between natural cells and the body environment, living cell-based anticancer therapeutics have been developed as promising drug carriers or active drugs for cancer therapy. In this review, we will survey recent advances in living cell-based anticancer therapeutics by leveraging their physiological characteristics, from long circulating properties to tumor-homing capacity and anticancer immune responses. In addition, future prospects of this field will be discussed.